FLT Menu Plan Worksheet

Name*
Date*
MM slash DD slash YYYY
Meal Replacement - 2 servings per day
Concentrated Protein (servings per day)*
Category 1 Vegetables (servings per day)*
Category 2 Vegetables (servings per day)*
Dairy (servings per day)*
Fruit (servings per day)*
Grain (servings per day)*
Legumes (servings per day)*
Nuts & Seeds (servings per day)*
Oil (servings per day)*
Total calories per day*
Wake up Time*
Comments*
Morning Meal Time*
Comments*
Snack Time*
Comments*
Mid-day Meal Time*
Comments*
Snack Time*
Comments*
Evening Meal Time*
Comments*
Snack Time*
Comments*
Water (ounces)*
Other Drinks (not listed with meals above)*
Activity/Exercise Type: Duration*
Relaxation Type: Duration*
Sleep Duration*